Man holding condom after HIV PrEP with Apretude®

HIV PrEP with Apretude®: how does Apretude® work?

Written on May 22, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

The first official report of HIV and AIDS was in the early 1980s.[1] Since then, the Centers for Disease Control and Prevention (CDC) has implemented various public health initiatives and surveillance programs to help prevent and treat HIV.[1] Due to the work of the CDC and partners, annual HIV cases have remained stable over the past several decades and have been declining over the last decade.[1] The newest available data shows that the yearly number of new HIV diagnoses declined by 8% from 2016 to 2019.[3] This article will review HIV and AIDS prevention strategies, specifically the PrEP medication Apretude®, and explain how Apretude® works.

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What is HIV and AIDS?

HIV, or human immunodeficiency virus, is a virus that attacks your body’s cells and immune system, making you more susceptible to infections and diseases and less able to fight illnesses.[2] HIV is transmitted from one person to another through contact with certain infected body fluids, like blood, semen or cum, rectal fluids, vaginal fluids, or breast milk.[4] For transmission to occur, these fluids must be in contact with mucous membranes, open cuts or sores, or directly injected into the bloodstream.[4]

The only way to know if you have HIV is to get tested.[5] Without proper treatment, HIV can progress to AIDS (acquired immunodeficiency syndrome).[5] There are three stages of HIV [5]:

  • Stage 1: Acute HIV infection involves flu-like symptoms. The virus is highly contagious during this stage.
  • Stage 2: Chronic HIV infection, also referred to as asymptomatic HIV infection. Though you may not experience any symptoms during this stage, you can still transmit the virus. With proper HIV treatment, you may never progress to stage 3.
  • Stage 3: This stage is considered AIDS and is the most severe form of HIV infection. At this stage, you are immunocompromised and can get a number of serious infections.

How to prevent HIV?

There are various ways to prevent HIV.[6] Prevention strategies include not having sex, never sharing needles, and using condoms appropriately when you have sex.[6] Another way to prevent HIV is to get tested so you know your status and can protect yourself and others from HIV. Medicines, like PrEP and PEP therapies, can also be prescribed as preventative measures.

Post-exposure prophylaxis (PEP) therapy uses medications after a one-time, high-risk event within 72 hours of exposure.[7] PrEP stands for pre-exposure prophylaxis and is medication taken to prevent getting HIV.[8] PrEP is only used if you are HIV-negative. When PrEP therapy is taken as prescribed by your healthcare provider, it has high efficacy. PrEP decreases the risk of getting HIV from sex by around 99% and from injection drug use by approximately 74%. There are currently two daily oral options for PrEP and one injection (Apretude®) available.[9]

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What is Apretude®?

Apretude® is the brand name for the drug cabotegravir, an extended-release suspension used to prevent HIV.[10,11] It is the first injectable PrEP treatment for HIV.[10] The official U.S. Food & Drug Administration (FDA) approved indication for Apretude® is for use in at-risk adults and adolescents who weigh at least 35 kg or 77 pounds for PrEP to reduce the risk of sexually acquired HIV.[11] You must have a negative HIV test before taking Apretude®.[11] Apretude® is started with two initial injections given a month apart, followed by an injection every two months thereafter.[11] Before initiating Apretude®, oral cabotegravir can be given to assess the tolerability of the drug.[10,11] Apretude® is only available with a prescription and administered by a healthcare provider.[11]

Apretude® has a severe safety or black box warning for the risk of drug resistance with the use of HIV PrEP in undiagnosed HIV infection.[11] Common adverse effects of Apretude® include injection site reactions, diarrhea, headache, fatigue, sleep disorders, nausea, dizziness, flatulence, abdominal pain, vomiting, rash, decreased appetite, back pain, and upper respiratory tract infection.[11] Other warnings and precautions are hypersensitivity reactions, liver toxicity, and depressive disorders.[11]

HIV PrEP with Apretude®: how does Apretude® work?

You’re probably wondering how Apretude® works. Apretude® is a long-acting antiretroviral medication against HIV.[11] Apretude® is considered an integrase inhibitor.[11] Integrase is an enzyme the HIV virus uses to insert its viral deoxyribonucleic acid (DNA) into human, or host, DNA to replicate.[12] By blocking integrase, the viral DNA is not integrated into the host DNA, preventing it from replicating and infecting other body cells.

Next steps with Everlywell

If you want to know your HIV status, you can test for HIV in the privacy of your own home with an at-home HIV test through Everlywell. Only a small blood sample via a simple finger stick is required, and you can view your results on our secure online platform. If you are positive, a healthcare provider will connect to discuss your case and the appropriate next steps with you.

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References

  1. HIV/AIDS timeline. Centers for Disease Control and Prevention. https://npin.cdc.gov/pages/hiv-and-aids-timeline. Accessed May 16, 2023.
  2. What are HIV and AIDS? HIV.gov. https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids/. Accessed May 18, 2023.
  3. Basic statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/statistics.html. Last Reviewed June 21, 2022. Accessed May 16, 2023.
  4. Body fluids that transmit HIV. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/hiv-transmission/body-fluids.html. Last Reviewed April 21, 2021. Accessed May 18, 2023.
  5. About HIV/AIDS. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/whatishiv.html. Last Reviewed June 30, 2022. Accessed May 16, 2023.
  6. Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/prevention.html. Last Reviewed June 1, 2021. Accessed May 16, 2023.
  7. Prep effectiveness. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/prep/prep-effectiveness.html. Last Reviewed June 6, 2022. Accessed May 18, 2023.
  8. Pre-exposure prophylaxis (prep). Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/risk/prep/index.html. July 5, 2022. Accessed May 16, 2023.
  9. US Public Health Service: Preexposure Prophylaxis for the Prevention of HIV Infection in the United States (2021 Update) – Clinical Practice Guideline. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf. Accessed May 17, 2023.
  10. FDA approves first injectable treatment for HIV pre-exposure prevention. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-injectable-treatment-hiv-pre-exposure-prevention. Accessed May 18, 2023.
  11. Apretude®.[prescribing information] Research Triangle Park, NC: ViiV Healthcare; 2021.
  12. Integrase: NIH. Integrase | NIH. https://clinicalinfo.hiv.gov/en/glossary/integrase. Accessed May 18, 2023.
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